| NPI | 1184902686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLAN BRADSHAW Member 601-736-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MS 461) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2018-06-01 |